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Case Report05-14-2025
Practice of ventilation in critically ill pediatric patients: protocol for an international, long–term, observational study, and results of the pilot feasibility study
- Relin van Vliet
, - Jonathan Willem Jochem Melger ,
- Frederique Paulus ,
- Reinout Alexander Bem ,
- Robert Gorge Theodoor Blokpoel , [ ... ],
- Martin Christiaan Jacques Kneyber
Abstract
Case ReportPractice of ventilation in critically ill pediatric patients: protocol for an international, long–term, observational study, and results of the pilot feasibility study
Critical Care Science. 2025;37:e20250398
DOI 10.62675/2965-2774.20250398
- Relin van Vliet ,
- Jonathan Willem Jochem Melger ,
- Frederique Paulus ,
- Reinout Alexander Bem ,
- Robert Gorge Theodoor Blokpoel ,
- Marcus Josephus Schultz ,
- David Michael Paul van Meenen ,
- Martin Christiaan Jacques Kneyber
Views122ABSTRACT
Objective:
This manuscript describes the protocol of an investigator-initiated, international, multicenter, long-term, prospective observational study named PRactice of VENTilation in PEDiatric Patients (PRoVENT-PED), designed to investigate the epidemiology, respiratory support practices and outcomes of critically ill pediatric patients.
Design:
Data will be collected biannually over 10 years during predefined 4-week intervals, with an additional optional period to accommodate data collection during an epidemic or pandemic. The specific focus of PRoVENT-PED will evolve as the study progresses, initially emphasizing collecting detailed ventilator data from invasively ventilated patients. In later phases, the focus will shift to noninvasive respiratory support and typical aspects of respiratory support, like patient-ventilator asynchronies, weaning practices, and rescue therapies, as extracorporeal support. PRoVENT-PED includes patients under 18 years of age, admitted to a participating intensive care unit, and receiving respiratory support. The endpoints vary with the focus in each phase but will always include a set of key settings and ventilation parameters and related outcomes. If applicable, potentially modifiable factors and associations with outcomes will be studied. The pilot feasibility study demonstrated that the electronic capturing system effectively collects all necessary data within a reasonable time limit, with little missing data.
Conclusion:
PRoVENT-PED is a 10-year, international, multicenter study focused on collecting data on respiratory support practices in critically ill pediatric patients. Its scope evolves from invasive to noninvasive ventilatory support, ultimately encompassing patient-ventilator asynchronies, weaning practices, and rescue therapies.
Keywords:artificialchildcritical illnessintensive care unitsmechanicalnoninvasive ventilationPandemicsPediatricRespirationVentilator weaningventilatorsSee moreViews122
Abstract
Case ReportPractice of ventilation in critically ill pediatric patients: protocol for an international, long–term, observational study, and results of the pilot feasibility study
Critical Care Science. 2025;37:e20250398
DOI 10.62675/2965-2774.20250398
- Relin van Vliet ,
- Jonathan Willem Jochem Melger ,
- Frederique Paulus ,
- Reinout Alexander Bem ,
- Robert Gorge Theodoor Blokpoel ,
- Marcus Josephus Schultz ,
- David Michael Paul van Meenen ,
- Martin Christiaan Jacques Kneyber
Views122ABSTRACT
Objective:
This manuscript describes the protocol of an investigator-initiated, international, multicenter, long-term, prospective observational study named PRactice of VENTilation in PEDiatric Patients (PRoVENT-PED), designed to investigate the epidemiology, respiratory support practices and outcomes of critically ill pediatric patients.
Design:
Data will be collected biannually over 10 years during predefined 4-week intervals, with an additional optional period to accommodate data collection during an epidemic or pandemic. The specific focus of PRoVENT-PED will evolve as the study progresses, initially emphasizing collecting detailed ventilator data from invasively ventilated patients. In later phases, the focus will shift to noninvasive respiratory support and typical aspects of respiratory support, like patient-ventilator asynchronies, weaning practices, and rescue therapies, as extracorporeal support. PRoVENT-PED includes patients under 18 years of age, admitted to a participating intensive care unit, and receiving respiratory support. The endpoints vary with the focus in each phase but will always include a set of key settings and ventilation parameters and related outcomes. If applicable, potentially modifiable factors and associations with outcomes will be studied. The pilot feasibility study demonstrated that the electronic capturing system effectively collects all necessary data within a reasonable time limit, with little missing data.
Conclusion:
PRoVENT-PED is a 10-year, international, multicenter study focused on collecting data on respiratory support practices in critically ill pediatric patients. Its scope evolves from invasive to noninvasive ventilatory support, ultimately encompassing patient-ventilator asynchronies, weaning practices, and rescue therapies.
Keywords:artificialchildcritical illnessintensive care unitsmechanicalnoninvasive ventilationPandemicsPediatricRespirationVentilator weaningventilatorsSee more
- Relin van Vliet
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Original Article04-16-2025
Practice of pediatric palliative extubation in Brazil: a case series
Critical Care Science. 2025;37:e20250176
Abstract
Original ArticlePractice of pediatric palliative extubation in Brazil: a case series
Critical Care Science. 2025;37:e20250176
DOI 10.62675/2965-2774.20250176
Views127ABSTRACT
Objective:
To describe the clinical profile, procedures applied and outcomes of patients undergoing palliative extubation in the pediatric intensive care unit at a high-complexity teaching hospital in the northeastern region of Brazil.
Methods:
This is a descriptive analysis of a case series that included patients aged under 14 years who underwent palliative extubation in the pediatric intensive care unit between 2016 and 2023 (seven years). Data on admission diagnoses, palliative extubation indications, applied therapies, and outcomes following palliative extubation were retrieved from medical records.
Results:
In total, 35 patients were included in the service database. In eight patients, reports could not be found, and these patients were excluded. Twenty-seven patients aged between five days and ten years, mostly females (51.8%) and those with chronic diseases (77.8%), were included in the study. All patients were classified on the basis of World Health Organization pediatric palliative care indication categories. Palliative extubation was considered after the identification of severe neurological impairment, inadequate response or absence of curative therapies, and failure of mechanical ventilation weaning. Palliative care approaches were discussed with the family in 74% of the cases before palliative extubation. Following palliative extubation, 48.1% of patients presented symptoms, and dyspnea (84.6%) and agitation (53.8%) were the most common symptoms. Death occurred in 88.8% of the children from 20 minutes to 38 days after palliative extubation at the hospital. Three children (11.2%) were discharged from the hospital.
Conclusion:
Palliative extubation was mostly performed in infants diagnosed with complex chronic conditions and severe and irreversible diseases, all of whom were referred to other palliative care. Death in the hospital while controlling for some symptoms was the main outcome.
Keywords:Airway extubationchildChronic diseasesInfant, newbornPalliative CarePatient dischargePediatric intensive care unitsRespiration, artificialVentilator weaningSee moreViews127Abstract
Original ArticlePractice of pediatric palliative extubation in Brazil: a case series
Critical Care Science. 2025;37:e20250176
DOI 10.62675/2965-2774.20250176
Views127ABSTRACT
Objective:
To describe the clinical profile, procedures applied and outcomes of patients undergoing palliative extubation in the pediatric intensive care unit at a high-complexity teaching hospital in the northeastern region of Brazil.
Methods:
This is a descriptive analysis of a case series that included patients aged under 14 years who underwent palliative extubation in the pediatric intensive care unit between 2016 and 2023 (seven years). Data on admission diagnoses, palliative extubation indications, applied therapies, and outcomes following palliative extubation were retrieved from medical records.
Results:
In total, 35 patients were included in the service database. In eight patients, reports could not be found, and these patients were excluded. Twenty-seven patients aged between five days and ten years, mostly females (51.8%) and those with chronic diseases (77.8%), were included in the study. All patients were classified on the basis of World Health Organization pediatric palliative care indication categories. Palliative extubation was considered after the identification of severe neurological impairment, inadequate response or absence of curative therapies, and failure of mechanical ventilation weaning. Palliative care approaches were discussed with the family in 74% of the cases before palliative extubation. Following palliative extubation, 48.1% of patients presented symptoms, and dyspnea (84.6%) and agitation (53.8%) were the most common symptoms. Death occurred in 88.8% of the children from 20 minutes to 38 days after palliative extubation at the hospital. Three children (11.2%) were discharged from the hospital.
Conclusion:
Palliative extubation was mostly performed in infants diagnosed with complex chronic conditions and severe and irreversible diseases, all of whom were referred to other palliative care. Death in the hospital while controlling for some symptoms was the main outcome.
Keywords:Airway extubationchildChronic diseasesInfant, newbornPalliative CarePatient dischargePediatric intensive care unitsRespiration, artificialVentilator weaningSee more -
Original Article02-28-2025
Uncovering knowledge of pediatric sepsis and recognition of septic shock: a survey among Brazilian pediatricians
Critical Care Science. 2025;37:e20250143
Abstract
Original ArticleUncovering knowledge of pediatric sepsis and recognition of septic shock: a survey among Brazilian pediatricians
Critical Care Science. 2025;37:e20250143
DOI 10.62675/2965-2774.20250143
Views173See moreABSTRACT
Objective:
To evaluate the ability of Brazilian pediatricians to recognize sepsis and septic shock in children.
Methods:
A cross-sectional multicenter survey was conducted among Brazilian pediatricians between May and June 2023, before the release of the new Phoenix sepsis criteria in 2024. An online electronic system was used for surveys to characterize the knowledge and skills of physicians in the diagnosis and treatment of sepsis in children. The questions related to the diagnosis and treatment of sepsis and septic shock in children were based on the International Pediatric Sepsis Consensus Conference, the American College of Critical Care Medicine Guidelines, and the Surviving Sepsis Campaign in Pediatrics. Descriptive statistical analyses were performed using R software.
Results:
Pediatricians were surveyed about the recognition, knowledge, and management of pediatric patients with sepsis and septic shock. The responses of 355 physicians from all regions of Brazil were analyzed, with the majority from the southeastern region of the country (53.3%). In clinical practice, the most utilized criteria for diagnosing sepsis included inappropriate tachycardia (92%), temperature alteration (88.2%), and the presence of a suspected or confirmed infectious focus (87.9%). For septic shock, capillary refill time alteration (87.1%), arterial hypotension (84.8%), and changes in the level of consciousness (82.2%) were the predominant indicators. A total of 55.6% pediatricians reported having the potential to obtain venous or intraosseous access within 5 minutes, and 59.3% could administer antibiotics within the first hour. Approximately one-quarter (27.5%) of the participants responded that it was possible to infuse 40 - 60mL/kg in 1 hour. The most commonly used solution for fluid resuscitation was isotonic saline (70.9%), followed by Ringer's lactate (45.0%). The infusion of a vasopressor was considered in patients who did not improve after receiving an infusion of 40 - 60mL/kg (75.8%).
Conclusion:
This is the first study to assess the knowledge of sepsis and septic shock among the Brazilian pediatric population. The results reveal a significant deficiency in the recognition of sepsis. This study demonstrated a gap between evidence and clinical practice. Adherence to international guidelines needs to be improved.
Views173Abstract
Original ArticleUncovering knowledge of pediatric sepsis and recognition of septic shock: a survey among Brazilian pediatricians
Critical Care Science. 2025;37:e20250143
DOI 10.62675/2965-2774.20250143
Views173See moreABSTRACT
Objective:
To evaluate the ability of Brazilian pediatricians to recognize sepsis and septic shock in children.
Methods:
A cross-sectional multicenter survey was conducted among Brazilian pediatricians between May and June 2023, before the release of the new Phoenix sepsis criteria in 2024. An online electronic system was used for surveys to characterize the knowledge and skills of physicians in the diagnosis and treatment of sepsis in children. The questions related to the diagnosis and treatment of sepsis and septic shock in children were based on the International Pediatric Sepsis Consensus Conference, the American College of Critical Care Medicine Guidelines, and the Surviving Sepsis Campaign in Pediatrics. Descriptive statistical analyses were performed using R software.
Results:
Pediatricians were surveyed about the recognition, knowledge, and management of pediatric patients with sepsis and septic shock. The responses of 355 physicians from all regions of Brazil were analyzed, with the majority from the southeastern region of the country (53.3%). In clinical practice, the most utilized criteria for diagnosing sepsis included inappropriate tachycardia (92%), temperature alteration (88.2%), and the presence of a suspected or confirmed infectious focus (87.9%). For septic shock, capillary refill time alteration (87.1%), arterial hypotension (84.8%), and changes in the level of consciousness (82.2%) were the predominant indicators. A total of 55.6% pediatricians reported having the potential to obtain venous or intraosseous access within 5 minutes, and 59.3% could administer antibiotics within the first hour. Approximately one-quarter (27.5%) of the participants responded that it was possible to infuse 40 - 60mL/kg in 1 hour. The most commonly used solution for fluid resuscitation was isotonic saline (70.9%), followed by Ringer's lactate (45.0%). The infusion of a vasopressor was considered in patients who did not improve after receiving an infusion of 40 - 60mL/kg (75.8%).
Conclusion:
This is the first study to assess the knowledge of sepsis and septic shock among the Brazilian pediatric population. The results reveal a significant deficiency in the recognition of sepsis. This study demonstrated a gap between evidence and clinical practice. Adherence to international guidelines needs to be improved.
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Original Article07-03-2024
Analysis of factors associated with admission to the intensive care unit of children and adolescents with COVID-19: application of a multilevel model
- Lecidamia Cristina Leite Damascena ,
- Aline Roseane Queiroz de Paiva Faria ,
- Nyellisonn Nando Nóbrega de Lucena ,
- Ana Hermínia Andrade e Silva ,
- Talita Tavares Alves de Almeida , [ ... ],
- Ana Maria Gondim Valença
Abstract
Original ArticleAnalysis of factors associated with admission to the intensive care unit of children and adolescents with COVID-19: application of a multilevel model
Critical Care Science. 2024;36:e20240068en
DOI 10.62675/2965-2774.20240068-en
- Lecidamia Cristina Leite Damascena ,
- Aline Roseane Queiroz de Paiva Faria ,
- Nyellisonn Nando Nóbrega de Lucena ,
- Ana Hermínia Andrade e Silva ,
- Talita Tavares Alves de Almeida ,
- Diana de Fátima Alves Pinto ,
- Hemílio Fernandes Campos Coêlho ,
- Ana Maria Gondim Valença
Views74ABSTRACT
Objective
To identify factors associated with hospitalization in the intensive care unit in children and adolescents with COVID-19.
Methods
This was a retrospective cohort study using secondary data of hospitalized children and adolescents (zero to 18 years old) with COVID-19 reported in Paraíba from April 2020 to July 2021, totaling 486 records. Descriptive analysis, logistic regression and multilevel regression were performed, utilizing a significance level of 5%.
Results
According to logistic regression without hierarchical levels, there was an increased chance of admission to the intensive care unit for male patients (OR = 1.98; 95%CI 1.18 - 3.32), patients with respiratory distress (OR = 2.43; 95%CI 1.29 - 4.56), patients with dyspnea (OR = 3.57; 95%CI 1.77 - 7.18) and patients living in large cities (OR = 2.70; 95%CI 1.07 - 6.77). The likelihood of requiring intensive care was observed to decrease with increasing age (OR = 0.94; 95%CI = 0.90 - 0.97), the presence of cough (OR = 0.32; 95%CI 0.18 - 0.59) or fever (OR = 0.42; 95%CI 0.23 - 0.74) and increasing Gini index (OR = 0.003; 95%CI 0.000 - 0.243). According to the multilevel analysis, the odds of admission to the intensive care unit increased in male patients (OR = 1.70; 95%CI = 1.68-1.71) and with increasing population size of the municipality per 100,000 inhabitants (OR = 1.01; 95%CI 1.01-1.03); additionally, the odds of admission to the intensive care unit decreased for mixed-race versus non-brown-skinned patients (OR = 0.981; 95%CI 0.97 - 0.99) and increasing Gini index (OR = 0.02; 95%CI 0.02 - 0.02).
Conclusion
The effects of patient characteristics and social context on the need for intensive care in children and adolescents with SARS-CoV-2 infection were better estimated with the inclusion of a multilevel regression model.
Keywords:adolescentchildCoronavirus infectionsCOVID-19Logistic modelsMultilevel analysisPediatric intensive care unitsSocial vulnerabilitySee moreViews74Abstract
Original ArticleAnalysis of factors associated with admission to the intensive care unit of children and adolescents with COVID-19: application of a multilevel model
Critical Care Science. 2024;36:e20240068en
DOI 10.62675/2965-2774.20240068-en
- Lecidamia Cristina Leite Damascena ,
- Aline Roseane Queiroz de Paiva Faria ,
- Nyellisonn Nando Nóbrega de Lucena ,
- Ana Hermínia Andrade e Silva ,
- Talita Tavares Alves de Almeida ,
- Diana de Fátima Alves Pinto ,
- Hemílio Fernandes Campos Coêlho ,
- Ana Maria Gondim Valença
Views74ABSTRACT
Objective
To identify factors associated with hospitalization in the intensive care unit in children and adolescents with COVID-19.
Methods
This was a retrospective cohort study using secondary data of hospitalized children and adolescents (zero to 18 years old) with COVID-19 reported in Paraíba from April 2020 to July 2021, totaling 486 records. Descriptive analysis, logistic regression and multilevel regression were performed, utilizing a significance level of 5%.
Results
According to logistic regression without hierarchical levels, there was an increased chance of admission to the intensive care unit for male patients (OR = 1.98; 95%CI 1.18 - 3.32), patients with respiratory distress (OR = 2.43; 95%CI 1.29 - 4.56), patients with dyspnea (OR = 3.57; 95%CI 1.77 - 7.18) and patients living in large cities (OR = 2.70; 95%CI 1.07 - 6.77). The likelihood of requiring intensive care was observed to decrease with increasing age (OR = 0.94; 95%CI = 0.90 - 0.97), the presence of cough (OR = 0.32; 95%CI 0.18 - 0.59) or fever (OR = 0.42; 95%CI 0.23 - 0.74) and increasing Gini index (OR = 0.003; 95%CI 0.000 - 0.243). According to the multilevel analysis, the odds of admission to the intensive care unit increased in male patients (OR = 1.70; 95%CI = 1.68-1.71) and with increasing population size of the municipality per 100,000 inhabitants (OR = 1.01; 95%CI 1.01-1.03); additionally, the odds of admission to the intensive care unit decreased for mixed-race versus non-brown-skinned patients (OR = 0.981; 95%CI 0.97 - 0.99) and increasing Gini index (OR = 0.02; 95%CI 0.02 - 0.02).
Conclusion
The effects of patient characteristics and social context on the need for intensive care in children and adolescents with SARS-CoV-2 infection were better estimated with the inclusion of a multilevel regression model.
Keywords:adolescentchildCoronavirus infectionsCOVID-19Logistic modelsMultilevel analysisPediatric intensive care unitsSocial vulnerabilitySee more
- Lecidamia Cristina Leite Damascena
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Original Article05-20-2024
Evaluation of the classifications of severity in acute respiratory distress syndrome in childhood by the Berlin Consensus and the Pediatric Acute Lung Injury Consensus Conference
- Roberta Costa Capela ,
- Raquel Belmino de Souza ,
- Maria de Fátima Pombo Sant’Anna ,
- Clemax Couto Sant’Anna
Abstract
Original ArticleEvaluation of the classifications of severity in acute respiratory distress syndrome in childhood by the Berlin Consensus and the Pediatric Acute Lung Injury Consensus Conference
Critical Care Science. 2024;36:e20240229en
DOI 10.62675/2965-2774.20240229-en
- Roberta Costa Capela ,
- Raquel Belmino de Souza ,
- Maria de Fátima Pombo Sant’Anna ,
- Clemax Couto Sant’Anna
Views88ABSTRACT
Objective
To compare two methods for defining and classifying the severity of pediatric acute respiratory distress syndrome: the Berlin classification, which uses the relationship between the partial pressure of oxygen and the fraction of inspired oxygen, and the classification of the Pediatric Acute Lung Injury Consensus Conference, which uses the oxygenation index.
Methods
This was a prospective study of patients aged 0 - 18 years with a diagnosis of acute respiratory distress syndrome who were invasively mechanically ventilated and provided one to three arterial blood gas samples, totaling 140 valid measurements. These measures were evaluated for correlation using the Spearman test and agreement using the kappa coefficient between the two classifications, initially using the general population of the study and then subdividing it into patients with and without bronchospasm and those with and without the use of neuromuscular blockers. The effect of these two factors (bronchospasm and neuromuscular blocking agent) separately and together on both classifications was also assessed using two-way analysis of variance.
Results
In the general population, who were 54 patients aged 0 - 18 years a strong negative correlation was found by Spearman’s test (ρ -0.91; p < 0.001), and strong agreement was found by the kappa coefficient (0.62; p < 0.001) in the comparison between Berlin and Pediatric Acute Lung Injury Consensus Conference. In the populations with and without bronchospasm and who did and did not use neuromuscular blockers, the correlation coefficients were similar to those of the general population, though among patients not using neuromuscular blockers, there was greater agreement between the classifications than for patients using neuromuscular blockers (kappa 0.67 versus 0.56, p < 0.001 for both). Neuromuscular blockers had a significant effect on the relationship between the partial pressure of oxygen and the fraction of inspired oxygen (analysis of variance; F: 12.9; p < 0.001) and the oxygenation index (analysis of variance; F: 8.3; p = 0.004).
Conclusion
There was a strong correlation and agreement between the two classifications in the general population and in the subgroups studied. Use of neuromuscular blockers had a significant effect on the severity of acute respiratory distress syndrome.
Keywords:Berlim classificationBronchial spasmchildNeuromuscular blocking agentsPALICC classificationRespiratory distress syndrome, newbornSeverity of illness indexSee moreViews88Abstract
Original ArticleEvaluation of the classifications of severity in acute respiratory distress syndrome in childhood by the Berlin Consensus and the Pediatric Acute Lung Injury Consensus Conference
Critical Care Science. 2024;36:e20240229en
DOI 10.62675/2965-2774.20240229-en
- Roberta Costa Capela ,
- Raquel Belmino de Souza ,
- Maria de Fátima Pombo Sant’Anna ,
- Clemax Couto Sant’Anna
Views88ABSTRACT
Objective
To compare two methods for defining and classifying the severity of pediatric acute respiratory distress syndrome: the Berlin classification, which uses the relationship between the partial pressure of oxygen and the fraction of inspired oxygen, and the classification of the Pediatric Acute Lung Injury Consensus Conference, which uses the oxygenation index.
Methods
This was a prospective study of patients aged 0 - 18 years with a diagnosis of acute respiratory distress syndrome who were invasively mechanically ventilated and provided one to three arterial blood gas samples, totaling 140 valid measurements. These measures were evaluated for correlation using the Spearman test and agreement using the kappa coefficient between the two classifications, initially using the general population of the study and then subdividing it into patients with and without bronchospasm and those with and without the use of neuromuscular blockers. The effect of these two factors (bronchospasm and neuromuscular blocking agent) separately and together on both classifications was also assessed using two-way analysis of variance.
Results
In the general population, who were 54 patients aged 0 - 18 years a strong negative correlation was found by Spearman’s test (ρ -0.91; p < 0.001), and strong agreement was found by the kappa coefficient (0.62; p < 0.001) in the comparison between Berlin and Pediatric Acute Lung Injury Consensus Conference. In the populations with and without bronchospasm and who did and did not use neuromuscular blockers, the correlation coefficients were similar to those of the general population, though among patients not using neuromuscular blockers, there was greater agreement between the classifications than for patients using neuromuscular blockers (kappa 0.67 versus 0.56, p < 0.001 for both). Neuromuscular blockers had a significant effect on the relationship between the partial pressure of oxygen and the fraction of inspired oxygen (analysis of variance; F: 12.9; p < 0.001) and the oxygenation index (analysis of variance; F: 8.3; p = 0.004).
Conclusion
There was a strong correlation and agreement between the two classifications in the general population and in the subgroups studied. Use of neuromuscular blockers had a significant effect on the severity of acute respiratory distress syndrome.
Keywords:Berlim classificationBronchial spasmchildNeuromuscular blocking agentsPALICC classificationRespiratory distress syndrome, newbornSeverity of illness indexSee more - Roberta Costa Capela
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Original Article12-22-2023
Translation and cross-cultural adaptation of the anchor points of the Cornell Assessment of Pediatric Delirium scale into Portuguese
- Marina dos Santos Ramos Barbosa ,
- Lívia Barboza Andrade ,
- Maria do Carmo Menezes Bezerra Duarte ,
- Roberta Esteves Vieira de Castro
Abstract
Original ArticleTranslation and cross-cultural adaptation of the anchor points of the Cornell Assessment of Pediatric Delirium scale into Portuguese
Critical Care Science. 2023;35(3):320-327
DOI 10.5935/2965-2774.20230165-en
- Marina dos Santos Ramos Barbosa ,
- Lívia Barboza Andrade ,
- Maria do Carmo Menezes Bezerra Duarte ,
- Roberta Esteves Vieira de Castro
Views64See moreABSTRACT
Objective:
To translate and cross-culturally adapt the Cornell Assessment of Pediatric Delirium anchor points from English to Brazilian Portuguese.
Methods:
For the translation and cross-cultural adaptation of the anchor points, all steps recommended internationally were followed after authorization for use by the lead author. The stages were as follows: translation of the original version into Portuguese by two bilingual translators who were native speakers of the target language, synthesis of the versions, reverse translation by two translators who were native speakers of the source language, review and synthesis of the back-translation, review by a committee of experts and preparation of the final version.
Results:
The translation and cross-cultural adaptation of the anchor points was conducted in accordance with recommendations. The linguistic and semantic issues that arose were discussed by a committee of judges, with 91.8% agreement, as determined using a Likert scale, after changes by consensus. After reanalysis by the authors, there were no changes, resulting in the final version, which was easy to understand and administer.
Conclusion:
The translation and cross-cultural adaptation of the anchor points of the Cornell Assessment of Pediatric Delirium scale into Portuguese spoken in Brazil were successful, maintaining the linguistic and semantic properties of the original instrument. The table of anchor points is easy to understand and will be helpful during the assessment of children younger than 24 months using the Cornell Assessment of Pediatric Delirium scale.
Views64Abstract
Original ArticleTranslation and cross-cultural adaptation of the anchor points of the Cornell Assessment of Pediatric Delirium scale into Portuguese
Critical Care Science. 2023;35(3):320-327
DOI 10.5935/2965-2774.20230165-en
- Marina dos Santos Ramos Barbosa ,
- Lívia Barboza Andrade ,
- Maria do Carmo Menezes Bezerra Duarte ,
- Roberta Esteves Vieira de Castro
Views64See moreABSTRACT
Objective:
To translate and cross-culturally adapt the Cornell Assessment of Pediatric Delirium anchor points from English to Brazilian Portuguese.
Methods:
For the translation and cross-cultural adaptation of the anchor points, all steps recommended internationally were followed after authorization for use by the lead author. The stages were as follows: translation of the original version into Portuguese by two bilingual translators who were native speakers of the target language, synthesis of the versions, reverse translation by two translators who were native speakers of the source language, review and synthesis of the back-translation, review by a committee of experts and preparation of the final version.
Results:
The translation and cross-cultural adaptation of the anchor points was conducted in accordance with recommendations. The linguistic and semantic issues that arose were discussed by a committee of judges, with 91.8% agreement, as determined using a Likert scale, after changes by consensus. After reanalysis by the authors, there were no changes, resulting in the final version, which was easy to understand and administer.
Conclusion:
The translation and cross-cultural adaptation of the anchor points of the Cornell Assessment of Pediatric Delirium scale into Portuguese spoken in Brazil were successful, maintaining the linguistic and semantic properties of the original instrument. The table of anchor points is easy to understand and will be helpful during the assessment of children younger than 24 months using the Cornell Assessment of Pediatric Delirium scale.
- Marina dos Santos Ramos Barbosa
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Letter to the Editor06-05-2023
Estimated continuous cardiac output based on pulse wave transit time in critically ill children: a report of two cases
- Humberto Magalhães Silva ,
- Raisa Sanches Uzun ,
- Isabel de Siqueira Ferraz ,
- Marcelo Barciela Brandão ,
- Tiago Henrique de Souza
Abstract
Letter to the EditorEstimated continuous cardiac output based on pulse wave transit time in critically ill children: a report of two cases
Critical Care Science. 2023;35(1):107-111
DOI 10.5935/2965-2774.20230305-en
- Humberto Magalhães Silva ,
- Raisa Sanches Uzun ,
- Isabel de Siqueira Ferraz ,
- Marcelo Barciela Brandão ,
- Tiago Henrique de Souza
Views82See moreABSTRACT
Cardiac output is an essential determinant of oxygen delivery, although unreliably measured on clinical examination and routine monitoring. Unfortunately, cardiac output monitoring is rarely performed in pediatric critical care medicine, with a limited availability of accurate methods for children. Herein, we report two pediatric cases in which noninvasive pulse-wave transit time-based cardiac output monitoring (esCCO, Nihon Kohden, Tokyo, Japan) was used. The esCCO system calculates cardiac output continuously by using the negative correlation between stroke volume and pulse wave transit time and requires only electrocardiogram monitoring, noninvasive blood pressure, and pulse oximetry signals. Before starting its use, esCCO should be calibrated, which can be done using patient information (gender, age, height, and body weight) or entering cardiac output values obtained by other methods. In both cases, when calibrations were performed using patient information, the agreement between esCCO and echocardiographic measurements was poor. However, after calibration with transthoracic echocardiography, the cardiac output values obtained by both methods remained similar after 2 hours and 18 hours. The results indicate that the esCCO system is suitable for use in children; however, further studies are needed to optimize its algorithm and determine its accuracy, precision, and trend in children.
Views82Abstract
Letter to the EditorEstimated continuous cardiac output based on pulse wave transit time in critically ill children: a report of two cases
Critical Care Science. 2023;35(1):107-111
DOI 10.5935/2965-2774.20230305-en
- Humberto Magalhães Silva ,
- Raisa Sanches Uzun ,
- Isabel de Siqueira Ferraz ,
- Marcelo Barciela Brandão ,
- Tiago Henrique de Souza
Views82See moreABSTRACT
Cardiac output is an essential determinant of oxygen delivery, although unreliably measured on clinical examination and routine monitoring. Unfortunately, cardiac output monitoring is rarely performed in pediatric critical care medicine, with a limited availability of accurate methods for children. Herein, we report two pediatric cases in which noninvasive pulse-wave transit time-based cardiac output monitoring (esCCO, Nihon Kohden, Tokyo, Japan) was used. The esCCO system calculates cardiac output continuously by using the negative correlation between stroke volume and pulse wave transit time and requires only electrocardiogram monitoring, noninvasive blood pressure, and pulse oximetry signals. Before starting its use, esCCO should be calibrated, which can be done using patient information (gender, age, height, and body weight) or entering cardiac output values obtained by other methods. In both cases, when calibrations were performed using patient information, the agreement between esCCO and echocardiographic measurements was poor. However, after calibration with transthoracic echocardiography, the cardiac output values obtained by both methods remained similar after 2 hours and 18 hours. The results indicate that the esCCO system is suitable for use in children; however, further studies are needed to optimize its algorithm and determine its accuracy, precision, and trend in children.
- Humberto Magalhães Silva
-
Original Article06-05-2023
Fitness checklist model for spontaneous breathing tests in pediatrics
- Bruno Silva Miranda ,
- Valéria Cabral Neves ,
- Yessa do Prado Albuquerque ,
- Emilly Freitas de Souza ,
- Adriana Koliski , [ ... ],
- José Eduardo Carreiro
Abstract
Original ArticleFitness checklist model for spontaneous breathing tests in pediatrics
Critical Care Science. 2023;35(1):66-72
DOI 10.5935/2965-2774.20230312-en
- Bruno Silva Miranda ,
- Valéria Cabral Neves ,
- Yessa do Prado Albuquerque ,
- Emilly Freitas de Souza ,
- Adriana Koliski ,
- Mônica Nunes Lima Cat ,
- José Eduardo Carreiro
Views72ABSTRACT
Objective:
To evaluate whether a model of a daily fitness checklist for spontaneous breathing tests is able to identify predictive variables of extubation failure in pediatric patients admitted to a Brazilian intensive care unit.
Methods:
This was a single-center, cross-sectional study with prospective data collection. The checklist model comprised 20 items and was applied to assess the ability to perform spontaneous breathing tests.
Results:
The sample consisted of 126 pediatric patients (85 males (67.5%)) on invasive mechanical ventilation, for whom 1,217 daily assessments were applied at the bedside. The weighted total score of the prediction model showed the highest discriminatory power for the spontaneous breathing test, with sensitivity and specificity indices for fitness failure of 89.7% or success of 84.6%. The cutoff point suggested by the checklist was 8, with a probability of extubation failure less than 5%. Failure increased progressively with increasing score, with a maximum probability of predicting extubation failure of 85%.
Conclusion:
The extubation failure rate with the use of this model was within what is acceptable in the literature. The daily checklist model for the spontaneous breathing test was able to identify predictive variables of failure in the extubation process in pediatric patients.
Keywords:Airway extubationChecklistchildIntensive care units, pediatricRespiration, artificialRespiratory function testSee moreViews72Abstract
Original ArticleFitness checklist model for spontaneous breathing tests in pediatrics
Critical Care Science. 2023;35(1):66-72
DOI 10.5935/2965-2774.20230312-en
- Bruno Silva Miranda ,
- Valéria Cabral Neves ,
- Yessa do Prado Albuquerque ,
- Emilly Freitas de Souza ,
- Adriana Koliski ,
- Mônica Nunes Lima Cat ,
- José Eduardo Carreiro
Views72ABSTRACT
Objective:
To evaluate whether a model of a daily fitness checklist for spontaneous breathing tests is able to identify predictive variables of extubation failure in pediatric patients admitted to a Brazilian intensive care unit.
Methods:
This was a single-center, cross-sectional study with prospective data collection. The checklist model comprised 20 items and was applied to assess the ability to perform spontaneous breathing tests.
Results:
The sample consisted of 126 pediatric patients (85 males (67.5%)) on invasive mechanical ventilation, for whom 1,217 daily assessments were applied at the bedside. The weighted total score of the prediction model showed the highest discriminatory power for the spontaneous breathing test, with sensitivity and specificity indices for fitness failure of 89.7% or success of 84.6%. The cutoff point suggested by the checklist was 8, with a probability of extubation failure less than 5%. Failure increased progressively with increasing score, with a maximum probability of predicting extubation failure of 85%.
Conclusion:
The extubation failure rate with the use of this model was within what is acceptable in the literature. The daily checklist model for the spontaneous breathing test was able to identify predictive variables of failure in the extubation process in pediatric patients.
Keywords:Airway extubationChecklistchildIntensive care units, pediatricRespiration, artificialRespiratory function testSee more
- Bruno Silva Miranda
child Archives - Critical Care Science (CCS)
